Heights University Hospital

All Charges

Charge

Type

Setting

Price

WIRE SYN K 2.0 285MM 492.21

Facility

$56.00

Hospital Charge Code	270603559
Hospital Revenue Code	272
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

WIRE SYN K 2.0 285MM 492.21

Facility

$56.00

Hospital Charge Code	270603559
Hospital Revenue Code	272
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$16.80
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$28.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$28.00

WIRE TAC SMOOTH OLIVE 1.6X30MM

Facility

$465.00

Hospital Charge Code	270698542
Hospital Revenue Code	272
Min. Negotiated Rate	$60.45
Max. Negotiated Rate	$232.50
Rate for Payer: Aetna Commercial	$139.50
Rate for Payer: Aetna Medicare Advantage	$139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.58
Rate for Payer: Cigna Commercial	$232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.45
Rate for Payer: Oxford Commercial	$232.50
Rate for Payer: Qualcare PPO/HMO/WC	$69.75
Rate for Payer: UnitedHealthcare Commercial	$232.50

WIRE TAC SMOOTH OLIVE 1.6X30MM

Facility

$465.00

Hospital Charge Code	270698542
Hospital Revenue Code	272
Min. Negotiated Rate	$69.75
Max. Negotiated Rate	$69.75
Rate for Payer: Qualcare PPO/HMO/WC	$69.75

WIRE THRD TIP 3.2x460mm

Facility

$780.00

Service Code	HCPCS C1769
Hospital Charge Code	270641740
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

WIRE THRD TIP 3.2x460mm

Facility

$780.00

Service Code	HCPCS C1769
Hospital Charge Code	270641740
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$234.00
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

WIRE THREADED .035x4

Facility

$150.00

Hospital Charge Code	270673752
Hospital Revenue Code	272
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

WIRE THREADED .035x4

Facility

$150.00

Hospital Charge Code	270673752
Hospital Revenue Code	272
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$75.00

WIRE TIGHTENER W/EYE

Facility

$1,566.00

Hospital Charge Code	270672159
Hospital Revenue Code	272
Min. Negotiated Rate	$203.58
Max. Negotiated Rate	$783.00
Rate for Payer: Aetna Commercial	$469.80
Rate for Payer: Aetna Medicare Advantage	$469.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$399.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$399.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$399.33
Rate for Payer: Cigna Commercial	$783.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.58
Rate for Payer: Oxford Commercial	$783.00
Rate for Payer: Qualcare PPO/HMO/WC	$234.90
Rate for Payer: UnitedHealthcare Commercial	$783.00

WIRE TIGHTENER W/EYE

Facility

$1,566.00

Hospital Charge Code	270672159
Hospital Revenue Code	272
Min. Negotiated Rate	$234.90
Max. Negotiated Rate	$234.90
Rate for Payer: Qualcare PPO/HMO/WC	$234.90

WIRE TIP NITI 1.1 2 ZONE

Facility

$695.00

Service Code	HCPCS C1713
Hospital Charge Code	270690432
Hospital Revenue Code	278
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$208.50
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

WIRE TIP NITI 1.1 2 ZONE

Facility

$695.00

Service Code	HCPCS C1713
Hospital Charge Code	270690432
Hospital Revenue Code	278
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$168.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

WIRE TREASURE 12FR 0.018X300

Facility

$875.00

Service Code	HCPCS C1769
Hospital Charge Code	270643115
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

WIRE TREASURE 12FR 0.018X300

Facility

$875.00

Service Code	HCPCS C1769
Hospital Charge Code	270643115
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

WIRE UNIGLIDE ANGL .035x150

Facility

$175.00

Hospital Charge Code	270677155
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

WIRE UNIGLIDE ANGL .035x150

Facility

$175.00

Hospital Charge Code	270677155
Hospital Revenue Code	272
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$87.50

WIRE UNIGLIDE ANGL .035x180

Facility

$1,092.45

Hospital Charge Code	270677156
Hospital Revenue Code	272
Min. Negotiated Rate	$163.87
Max. Negotiated Rate	$163.87
Rate for Payer: Qualcare PPO/HMO/WC	$163.87

WIRE UNIGLIDE ANGL .035x180

Facility

$1,092.45

Hospital Charge Code	270677156
Hospital Revenue Code	272
Min. Negotiated Rate	$142.02
Max. Negotiated Rate	$546.23
Rate for Payer: Aetna Commercial	$327.74
Rate for Payer: Aetna Medicare Advantage	$327.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$278.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$278.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$278.57
Rate for Payer: Cigna Commercial	$546.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.02
Rate for Payer: Oxford Commercial	$546.23
Rate for Payer: Qualcare PPO/HMO/WC	$163.87
Rate for Payer: UnitedHealthcare Commercial	$546.23

WIRE UNIGLIDE ANGL .035x180

Facility

$175.00

Hospital Charge Code	270677156N
Hospital Revenue Code	272
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$87.50

WIRE UNIGLIDE ANGL .035x180

Facility

$175.00

Hospital Charge Code	270677156N
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

WIRE UNIGLIDE ANGL .035x260

Facility

$175.00

Hospital Charge Code	270677157
Hospital Revenue Code	272
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$87.50

WIRE UNIGLIDE ANGL .035x260

Facility

$175.00

Hospital Charge Code	270677157N
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

WIRE UNIGLIDE ANGL .035x260

Facility

$175.00

Hospital Charge Code	270677157
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

WIRE UNIGLIDE ANGL .035x260

Facility

$175.00

Hospital Charge Code	270677157N
Hospital Revenue Code	272
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$87.50

WIRE UNIGLIDE ANGL .035x320

Facility

$175.00

Hospital Charge Code	270677158
Hospital Revenue Code	272
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$87.50

Know your out-of-pocket cost for care.

All Charges